Please select the membership you would like to cancel.*
Why are you leaving?*
How would you rate the coaching staff?*
How clean were the facilities?*
How satisfied were you with the facilities?*
How satisfied were you with your overall experience?*
Would you recommend us to your friends? *
1. By submitting this form, I am giving Flex Affect my 15 day written notice to cancel my membership.
2. I understand that my membership will be cancelled 15 days from the date this form was submitted and 30% of the remaining balance charged to payment method on file. Should I choose to rejoin Flex Affect after the termination of my membership, (which we hope you do), I will have to pay the current rate at that time.
3. I understand that I will be charged/debited one additional month if I provide less than 15 day notice prior to my next billing period. Upon completion of the 15 day cancellation period, my membership shall then be considered terminated.
4. I understand that if I am requesting to cancel my membership while it is on hold, that the membership will become active and the 15 day cancellation window will begin.
5. I have turned in my membership access card. $10 fee if not turned in.
Yes, I agree to each of the above.*